首荟通便胶囊联合双歧杆菌三联活菌胶囊治疗气阴两虚型老年功能性便秘的效果

Effect of Shouhui Tongbian Capsules and Bifidobacterium Triple Viable Bacteria Capsules in treatment of senile functional constipation differentiated as deficiency of qi and yin syndrome

  • 摘要:
      目的  观察首荟通便胶囊联合双歧杆菌三联活菌胶囊治疗气阴两虚型老年功能性便秘(FC)的效果。
      方法  选取183例老年FC患者为研究对象,采用随机数字表法分为对照1组、对照2组和研究组,每组61例。所有患者均给予常规综合治疗,对照1组在此基础上应用双歧杆菌三联活菌胶囊治疗,对照2组应用首荟通便胶囊治疗,研究组采用双歧杆菌三联活菌胶囊联合首荟通便胶囊治疗。比较治疗前、治疗4周后3组中医证候积分、Bristol评分、排便困难评分。抽取清晨空腹静脉血,检测3组的胃动素(MTL)、胃泌素(GAS)、P物质(SP)等胃肠激素水平。记录3组肛管静息压、肛管收缩压、最大耐受容量等肛门直肠动力学指标。比较治疗后3组治疗总有效率、不良反应发生率及复发率。
      结果  研究组治疗总有效率高于对照1组和对照2组,差异有统计学意义(P < 0.05)。3组治疗前后中医证候积分、排便困难评分、Bristol评分及血清MTL、GAS、SP水平比较,差异有统计学意义(P < 0.05)。治疗后,研究组中医证候积分、排便困难评分低于对照1组和对照2组,Bristol评分及MTL、GAS、SP水平均高于对照1组和对照2组,差异有统计学意义(P < 0.05)。治疗后,3组肛管静息压、肛管收缩压均较治疗前升高,最大耐受容量较治疗前降低,差异有统计学意义(P < 0.05);研究组肛管静息压、肛管收缩压高于对照1组和对照2组,最大耐受容量低于对照1组和对照2组,差异有统计学意义(P < 0.05)。研究组复发率低于对照1组和对照2组,差异有统计学意义(P < 0.05)。3组不良反应发生率比较,差异无统计学意义(P>0.05)。
      结论  采用首荟通便胶囊联合双歧杆菌三联活菌胶囊治疗气阴两虚型老年FC患者的疗效较为理想,可明显改善便秘症状,有效上调胃肠激素水平,显著改善肛门直肠动力学指标,降低复发率,且用药安全性较高。

     

    Abstract:
      Objective  To observe the effect of Shouhui Tongbian Capsules combined with Bifidobacterium Triple Viable Bacteria Capsules in treatment of senile functional constipation (FC) differentiated as deficiency of both qi and yin.
      Methods  A total of 183 elderly FC patients were selected as study objects and were divided into control group 1, control group 2 and study group by random number table method, with 61 patients in each group. All patients were given conventional comprehensive treatment. The control group 1 was treated with Bifidobacterium Triple Viable Bacteria Capsules, the control group 2 was treated with Shouhui Tongbian Capsules, and study group was treated with Bifidobacterium Triple Viable Bacteria Capsules combined with Shouhui Tongbian Capsules. Before and 4 weeks after treatment, TCM syndrome scores, Bristol scores and defecation difficulty scores were evaluated in the three groups. Fastening venous blood was collected in the morning to detect the levels of gastrointestinal hormones such as motilin (MTL), gastrin (GAS) and substance P (SP) in the three groups. Anorectal dynamics indexes, such as resting pressure of anal canal, systolic pressure of anal canal and maximum tolerance capacity were detected in three groups. After treatment, the incidence of adverse reactions, the recurrence rate and total effective rate of the three groups were compared.
      Results  The total effective rate of the study group was significantly higher than that of the control groups 1 and 2 (P < 0.05). There were significant differences in TCM syndrome score, defecation difficulty score, Bristol score and serum levels of MTL, GAS and SP before and after treatment among the three groups (P < 0.05). After treatment, TCM syndrome score and defecation difficulty score in the study group were significantly lower than those in control groups 1 and 2, and Bristol score, MTL, GAS and SP levels were significantly higher than those in the control groups 1 and 2(P < 0.05). After treatment, the anal canal resting pressure and anal canal systolic blood pressure in the three groups were increased compared with before treatment, and the maximum tolerance capacity was decreased compared with before treatment (P < 0.05). The anal canal resting pressure and anal canal systolic blood pressure in the study group were significantly higher than those in the control groups 1 and 2, and the maximum tolerance capacity was significantly lower than that in the control groups 1 and 2 (P < 0.05). The recurrence rate of study group was significantly lower than that of the control groups 1 and 2 (P < 0.05). There was no significant difference in the incidence of adverse drug reactions among three groups (P < 0.05).
      Conclusion  For elderly FC patients with deficiency of both qi and yin, Shouhui Tongbian Capsules combined with Bifidobacterium Triple Viable Bacteria Capsules has a relatively ideal curative effect, which can significantly improve constipation symptoms, effectively up-regulate gastrointestinal hormone levels, significantly improve anorectal dynamics, greatly reduce the recurrence rate, and has higher safety.

     

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